Understanding How Physicians Think

At the Becker's Hospital Review Annual Meeting in Chicago on May 9, Jeff Leland, CEO of Blue Chip Surgical Center Partners, discussed differences between physicians and hospital executives, and how relationships between the two can be strengthened.

Mr. Leland said healthcare reform is demanding a different style of management from hospitals and health systems, and the traditional, hierarchal model is not enough. Instead, Mr. Leland said hospitals need a management model that is flexible, adaptable, entrepreneurial and responsive to the healthcare industry.

Ideally, this model should be led by physicians, but Mr. Leland said there is a two-way caveat: "Doctors absolutely do not understand organizational leadership. They don't understand how to lead and run organizations. On the other hand, most organizational leaders and administrators don't understand how doctors think."

Although there are exceptions, Mr. Leland said physicians — by nature of their craft — tend to be:

• Decisive.

• Self-reliant.

• Prone to distancing themselves from non-physicians, especially as they grow older.

• Fiercely independent. Although they may look to colleagues for guidance, they feel more comfortable being independent.

• Courageous and eager to tackle problems. "Of any group I've ever worked with, they'll wade right into the thick of the problem," said Mr. Leland.

• Lack of negotiation skills. "I don't mean just about a business deal. Doctors — there is no give and take."

Mr. Leland then discussed the broad concept of organizational culture, an umbrella that includes (a) expert culture and (b) collective culture. He said most physicians find themselves interacting in an expert culture, which is not defined by a mission statement or organizational vision. In an expert culture, behavior is primarily motivated by self-interest. Accountability, risk-taking, achievement, and quick decision-making are crucial.

On the other hand, non-physician hospital staff and other executives may find themselves in a collective culture, which embraces an organization's mission, value and vision statements. In a collective culture, individuals tend to work in groups and avoid conflict and risk.

"Neither culture is right or wrong," said Mr. Leland. "I think the common bond with physicians is the vision: Where you want to go and what you want to do. From the physician standpoint, they want to understand that they can accomplish what they want to do under the hospital's vision statement."

Mr. Leland said the key to moving forward is to convene conversations that matter, cultivate proximity, rebuild the spirit of entrepreneurialism, honor the individual and the group, and to focus on new business opportunities. Mr. Leland also recommended hospital leaders ride with the troops. "The way of the future is for hospital executives need to find their ways to the doctors' office and spend more time with the doctors."

More Articles on Hospital-Physician Relationships:

3 Ways to Develop Physician Leadership
4 Steps to Improved Physician Communication
11 Specialties With Most Satisfied Physicians

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